PHRM 825: RA Flashcards
At what age does RA occur?
- Any age
- Shortens life span by 3-18 years
- Onset is usually between 30-50 years
In what gender is RA more common?
Female
What is RA?
-Chronic autoimmune disease
How does RA affect the joints?
- Synovial space in joints infiltrated with inflammatory cells (macrophage, t-cells, plasma cells)
- These release cytokines which are mediators of immune and inflammatory response leading to cellular proliferation and death (IL-1, TNF, IL-6, IL-7)
What is a pannus and how does it affect the joint?
- Pannus is inflamed proliferating synovium
- Invades cartilage and bone producing erosion which ultimately destroy joints
What is the clinical presentation of RA?
- Prodrome (non-specific symptoms)
- Stiffness/muscle ache
- Fatigue
- Joint pain
- Weakness
- Low grade fever
- Loss of appetite
What joints are most commonly affected by RA?
- Hands
- Wrists
- Feet
What extra-articular manifestations can someone with RA have?
- Rheumatoid nodules
- Vasculitis
- Pulmonary
- Ocular
- Cardiac
- Felty’s
What are rheumatoid nodules?
- Nodules located on pressure points
- Usually found in hands, elbows, and forearms
- More common in erosive disease
- 20% of pts affected
What is vasculitis?
- Inflammation of small, superficial vessels
- Depends upon duration of disease
- Associated with stasis ulcers
- Infarction can lead to necrosis
What pulmonary manifestations can someone with RA experience?
- Pleural effusions
- Pulmonary fibrosis
- Nodules
What ocular manifestations can someone with RA experience?
- Inflammation: sclera, episclera, cornea
- Nodules on sclera
- Keratoconjunctivitis sicca (itchy, dry eyes + inflammation)
What is Sjorgens syndrome?
Keratoconjunctivitis Sicca + RA
What cardiac manifestations can someone with RA experience?
- Increased risk of CV mortality
- Pericarditis
- Conduction abnormalities
What is Felty’s
Splenomegala (inflamed spleen) and neutropenia
